Death cap fungi linked to deaths and hospitalizations

An unusually wet December contributed to an abundance of death cap fungi, or Amanita phalloideson the Central Coast and Northern California, causing what authorities describe as an unprecedented outbreak of serious illness and death among people who eat the mushrooms.

Public health officials are issuing a second warning this winter, this time urging the public not to pick wild mushrooms, noting that many people have mistakenly eaten the death cap which, when eaten, can cause serious liver damage and, in some cases, lead to death.

In the past 26 years, “we haven’t had a season as deadly as this one, both in terms of total cases and deaths and liver transplants,” said Craig Smollin, medical director of the San Francisco division of the California Poison Control System.

“I think this is probably the largest outbreak we’ve ever seen in California.”

Many of the cases, officials say, involve people from Mexico and elsewhere for whom the death cap resembles an edible mushroom in their home country.

The California Department of Public Health reported 35 illnesses linked to the deadly ceiling, including three deaths and three liver transplants, between November 18 and January 6. Those affected ranged in age from 19 months to 67 years.

In a typical year, the California Poison Control Center may receive up to five cases of illnesses linked to poisonous mushrooms, according to officials.

The last major outbreak of mushroom-related illness in California occurred in 2016 with 14 reported cases, and while there were no deaths, three people required liver transplants and one child suffered “permanent neurological impairment.”

The death cap is the most toxic mushroom in the world, responsible for 90% of mushroom-related deaths.

Where the mortality epidemic is concentrated

When state public health officials first warned of the dangers of the deadly fungus in December, large reported outbreaks of illness occurred in Monterey and the San Francisco Bay areas.

Reported hospitalizations have since increased to include Alameda, Contra Costa, Monterey, San Francisco, San Luis Obispo, San Mateo, Santa Clara, Santa Cruz and Sonoma counties.

Deathcap mushrooms are known to grow throughout the state of California, but they thrive in shady, moist, or humid environments under cultivated live oaks and cork oaks.

Deathcap mushrooms bloom especially well after fall and winter rains. Once they sprout, their tall, graceful features are very visible and attract people’s attention, said David Campbell, a mushroom eating expert and mycophagist.

Who eats the death cap by mistake

People who accidentally consumed the death cap typically foraged for mushrooms in the wild, alone or in groups, officials said.

Among those affected are monolingual speakers of Spanish, Chinese, Mandarin and Mixtec, as well as foragers who might mistake the deathcap mushroom for edible mushrooms from their home countries, experts say.

“So they have a false sense of security in their knowledge, thinking they know what they’re doing, but that only applies to their home country,” Campbell said.

“We are seeing a number of patients appear to be of Hispanic origin,” said Dr. Rita Nguyen, deputy public health officer at the California Department of Public Health.

In November, a Salinas family said they went hiking in their community and found the deathcap, which looked like an edible mushroom they would search for in their hometown of Oaxaca, KSBW Action News reported.

Laura Marcelino and Carlos Diaz took the mushrooms home, cooked them and ate them – not their children. They both vomited, had diarrhea for an entire day and were later hospitalized, KSBW Action News reported. Marcelino’s condition improved but Diaz’s health declined exponentially to the point that he fell into a coma and was placed on a list to receive a liver transplant, according to media reports.

Why people mistakenly eat deathcap mushrooms

The three deadliest mushrooms in California include deathcap, destroying angel (Ocreate Amanita) and the mortal Galerina (Marginated galerina), according to the Bay Area Mycological Society.

The death cap mushroom has a smooth, dome-shaped cap with olive or yellowish green tones. Under its cap are gills and white spores.

It can be confused with mushroom species Volvariella, which is edible.

These mushrooms appear similar because they have a volva, a cup-shaped structure at the base of the mushroom’s stem, and are whitish, but they lack an important key characteristic ring, or annulus, around its stem, said Ari Jumpponen, distinguished professor of biology at Kansas State University.

Jumpponen said that Volvariella species can be found in Oaxaca.

What symptoms can you expect after eating a death cap?

No amount of Deadly Ceiling is safe to consume.

“I also want to emphasize that there is nothing, there is no cooking the mushroom or freezing the mushroom that could inactivate the toxin,” Smollin said.

Deathcap’s toxic toxins can cause delayed gastrointestinal symptoms that may not appear until 6 to 24 hours after eating it.

Some of the early symptoms that may disappear within a day include:

• Nausea
• Vomiting
• Diarrhea
• Abdominal pain
• Lower blood pressure
• Fatigue
• Confusion

Mild symptoms may be just the start of a more serious reaction.

Serious symptoms can develop within 48 to 96 hours, including progressive liver damage and, in some cases, complete liver failure or even death, Smollin said.

If you have eaten a foraged mushroom and begin to experience adverse symptoms, call the California Poison Control Hotline at 1-800-222-1222 for free, confidential expert advice in multiple languages. If you suspect mushroom poisoning, call 911.